title: Total testing process applied to therapeutic drug monitoring: impact on patients' outcomes and economics.
abstract: The Total Testing Process (TTP) refers to the sequence of 11 steps of laboratory testing, beginning with a clinical question prompted by the patient-clinician encounter and concluding with the impact of the test result on patient care. TTP when applied to therapeutic drug monitoring (TDM) emphasizes that TDM must be considered a process involving a series of steps and interrelated activities and not viewed simply as a numerical value for a serum drug concentration. TTP is also an ideal format for organizing and identifying the system-related and patient-centered variables used in outcomes assessment of TDM, as well as providing a template for collecting the cost data needed for economic analyses. Examples are provided for improving application of TDM by practitioners, clinical laboratories, and educators.
authors.affiliation: Center for Outcomes Assessment in Healthcare, Bouvé College of Pharmacy and Health Sciences, Northeastern University, Boston, MA 02115, USA. G.Schumacher@lynx.neu.edu
authors.forename: G E
authors.initials: GE
authors.lastname: Schumacher
authors.forename: J T
authors.initials: JT
authors.lastname: Barr
mesh_terms: D001774:Blood Chemical Analysis; D016903:Drug Monitoring / Q000191:economics; D006801:Humans; D017063:Outcome Assessment, Health Care; D005791:Patient Care; D010672:Phenytoin / Q000097:blood; D013806:Theophylline / Q000097:blood
chemical_list: D010672:Phenytoin; D013806:Theophylline